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FOR THE DENTAL PATIENT ...

0.7 to 1.2 parts per million. Naturally occurring Fluoride fluoride that may be below or above these levels is present in some water supplies. Nature’s If your comes from a public or community water supply, contact the local water fighter supplier to determine the fluoride level. You also can check with your local, county or state health aries (cavities) used to be a fact of life. department. However, during the past few decades, Two Internet sites also supply information for tooth decay has been reduced dramati- many communities. One is the U.S. Environ- cally. The key reason: fluoride. Fluoride mental Protection Agency’s (EPA) Web site, “Con- is a that may occur naturally in sumer Confidence Reports,” which highlights Call drinking water sources—oceans, lakes, rivers annual water quality reports (“www.epa.gov/ and underground water. Extensive research has safewater/ccr/”). Another source is the CDC’s fluo- shown that optimal levels of fluoride not only ridation Web site, “My Water’s Fluoride” reduce caries in children and adults, but also help (“apps.nccd.cdc.gov/MWF/Index.asp”). repair the early stages of tooth decay. If your drinking water comes from a private , a certified laboratory can test samples and FLUORIDE EXPOSURE provide data. Contact your local or state health You may receive fluoride in topical or systemic department for information about laboratories forms. Topical fluoride (applied to the surface of the that provide this service. teeth) is delivered through many , mouthrinses and gels, as well as through foams and WATER QUALITY REPORTS varnishes applied in the dental office. Topical fluo- In 1999, the EPA began requiring water suppliers rides help strengthen the surface of tooth enamel. to provide annual drinking water quality reports to Systemic fluoride is intended to be ingested. This their customers. Water quality reports typically form includes fluoridated water and dietary fluoride may be mailed to the customer, placed in the local supplements, such as tablets, drops or lozenges. newspaper or made available through the Internet Systemic fluoride is integrated into children’s teeth at about July 1 each year. To obtain a copy of the as their tooth structures form. report, contact your local water supplier. The name A reduction in tooth decay is achieved through of the water system (often not the name of the city) exposure to topical fluorides, systemic fluorides or can be found on your water bill. If the name of the both. provides both types of system is unknown, contact the local health depart- exposure. ment. The EPA does not regulate private drinking water , but the agency recommends that pri- SOURCES OF FLUORIDE vate well water be tested every year. Community water fluoridation is an effective and Talk with your dentist about ways you can inexpensive means of achieving the fluoride expo- achieve optimal fluoride exposure for good oral sure necessary to help prevent tooth decay. health. ■

Studies show that water fluoridation continues to 1. Newbrun E. Effectiveness of water fluoridation. J Public Health be effective in reducing tooth decay by about 20 to Dent 1989;49(5 spec no.):279-289. 1,2 2. Brunelle JA, Carlos JP. Recent trends in dental caries in U.S. chil- 40 percent. dren and the effect of water fluoridation. J Dent Res 1990;69(spec no.): Leading health organizations, including the 723-727. American Dental Association, the U.S. Centers Prepared by the ADA in cooperation with The Journal of the for Disease Control and Prevention (CDC) and the American Dental Association and the ADA Division of Science. Unlike other portions of JADA, this page may be clipped and copied as a American Academy of Pediatric Dentistry, sup- handout for patients, without first obtaining reprint permission from port community water fluoridation on the basis of the ADA Publishing Division. Any other use, copying or distribution, whether in printed or electronic form, is strictly prohibited without the overwhelming weight of scientific evidence, prior written consent of the ADA Publishing Division. which continues to support its safety and effec- “For the Dental Patient” provides general information on dental tiveness. Water fluoridation helps prevent tooth treatments to dental patients. It is designed to prompt discussion between dentist and patient about treatment options and does not sub- decay in both children and adults. stitute for the dentist’s professional assessment based on the individual The optimal fluoride level in drinking water is patient’s needs and desires.

126 JADA, Vol. 140 http://jada.ada.org January 2009

Copyright © 2009 American Dental Association. All rights reserved. Reprinted by permission.